Coenen Indira, De Baetselier Elyne, Foulon Veerle, Dilles Tinne
University of Antwerp, NuPhaC, Centre for Research and Innovation in Care, Faculty of Medicine and Health Sciences, Antwerp, Belgium.
KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, Leuven, Belgium.
Int J Integr Care. 2024 Apr 9;24(2):5. doi: 10.5334/ijic.7581. eCollection 2024 Apr-Jun.
Although there is evidence that interprofessional, person-centred, integrated care is important for optimising pharmaceutical care of older people with polypharmacy, this way of working is often not implemented in practice. The aim of this study was to identify common characteristics of successful interprofessional initiatives and factors influencing their implementation, in order to close this know-do gap.
A qualitative, explorative design with in-depth semi-structured interviews was used. Flemish primary healthcare professionals (HCPs) and patients aged over 75, involved in successful initiatives of interprofessional pharmaceutical care for older people with polypharmacy, were included. Inductive analysis was conducted to identify main topics.
Fifteen HCPs and four patients, involved in nine interprofessional initiatives, were interviewed. In all initiatives the HCPs had interprofessional consultations about older people with polypharmacy. The interaction between the characteristics of the initiatives and the context had an important impact on the implementation. These context factors were positioned under the micro-, meso- and macro context. Implementation strategies, actions to enhance the initiatives' adoption, corresponded with three themes: communication and influence, coordination by different stakeholders, and (dis)incentives.
The identification of these success factors might inspire HCPs, providers of interprofessional education and policymakers to facilitate interprofessional pharmaceutical care.
尽管有证据表明,跨专业、以患者为中心的综合护理对于优化患有多种疾病的老年人的药物治疗护理很重要,但这种工作方式在实践中往往并未得到实施。本研究的目的是确定成功的跨专业举措的共同特征以及影响其实施的因素,以弥合这一认知与实践的差距。
采用定性、探索性设计,进行深入的半结构化访谈。纳入了参与针对患有多种疾病的老年人的跨专业药物治疗护理成功举措的弗拉芒地区初级医疗保健专业人员(HCPs)和75岁以上的患者。进行归纳分析以确定主要主题。
对参与9项跨专业举措的15名HCPs和4名患者进行了访谈。在所有举措中,HCPs都针对患有多种疾病的老年人进行了跨专业会诊。举措的特征与背景之间的相互作用对实施产生了重要影响。这些背景因素分为微观、中观和宏观背景。实施策略,即促进举措采用的行动,对应三个主题:沟通与影响、不同利益相关者的协调以及(去)激励措施。
确定这些成功因素可能会激励HCPs、跨专业教育提供者和政策制定者推动跨专业药物治疗护理。